06 First Symptoms

After I graduated from MIT I went to Princeton, and I would go home on vacations to see Arlene. One time when I went to see her, Arlene had developed a bump on one side of her neck. She was a very beautiful girl, so it worried her a little bit, but it didn’t hurt, so she figured it wasn’t too serious. She went to her uncle, who was a doctor. He told her to rub it with omega oil.

Then, sometime later, the bump began to change. It got bigger-or maybe it was smaller-and she got a fever. The fever got worse, so the family doctor decided Arlene should go to the hospital. She was told she had typhoid fever. Right away, as I still do today, I looked up the disease in medical books and read all about it.

When I went to see Arlene in the hospital, she was in quarantine-e-we had to put on special gowns when we entered her room, and so on. The doctor was there, so I asked him how the Wydell test came out-it was an absolute test for typhoid fever that involved checking for bacteria in the feces. He said, “It was negative.”
“What? How can that be!” I said .
“Why all these gowns, when you can’t even find the bacteria in an experiment? Maybe she doesn’t have typhoid fever!”
The result of that was that the doctor talked to Arlene’s parents, who told me not to interfere.
“After all, ‘he’s the doctor’s , You’re only her fiance.”
I’ve found out since that such people don’t know what they’re doing, and get insulted when you make some suggestion or criticism. I realize that now, but I wish I had been much stronger then and told her parents that the doctor was an idiot-which he was-and didn’t know what he was doing. But as it was, her parents were in charge of it.

Anyway, after a little while, Arlene got better, apparently: the swelling went down and the fever went away. But after some weeks the swelling started again; and this time she went to another doctor. This guy feels under her armpits and in her groin, and so on, and notices there’s swelling in those places, too. He says the problem is in her lymphatic glands, but he doesn’t yet know what the specific disease is. He will consult with other doctors.

As soon as I hear about it I go down to the library at Princeton and look up lymphatic diseases, and find “Swelling of the Lymphatic Glands. ⁽¹⁾ Tuberculosis of the lymphatic glands. This is very easy to diagnose … .”-so I figure this isn’t what Arlene has,. because the doctors are having trouble trying to figure it out.
I started reading about some other diseases: lymphodenema, lymphodenoma, Hodgkin’s disease, all kinds of other things; they’re all cancers of one crazy form or another. The ‘only difference between lymphodenema and lymphodenoma was, as far as I could make out by reading it very carefully, that if the patient dies, it’s lymphadenoma; if the patient survives-at least for a while-then it’s lymphodenema.

At any rate, I read through all the lymphatic diseases, and decided that the most likely possibility was that Arlene had an incurable disease. Then I half smiled to myself, thinking, “I bet everybody who reads through a medical book thinks they have a fatal disease.” And yet, after reading everything very carefully, I couldn’t find any other possibility. It was serious.

Then I went to the weekly tea at Palmer Hall, and found myself talking to the mathematicians just as I always did, even though I had just found out that Arlene probably had a fatal disease. It was very strange-like having two minds.
When I went to visit her, I told Arlene the joke about the people who don’t know any medicine reading the medical book and always assuming they have a fatal disease. But I also told her I thought we were in great difficulty, and that the best I could figure out was that’ she had an incurable diseases. We discussed the various diseases, and I told her what. each one was like.

One of the diseases I told Arlene about was Hodgkin’s disease. When she next saw per doctor, she asked him about it: “Could it be Hodgkin’s disease?”
He said” “Well, yes, that’s a possibility.”
When she’ went to the county hospital, the doctor wrote the following diagnosis: “Hodgkin’s disease-?”
So I realized that the doctor didn’t know any more than I did about this problem.

The county hospital gave Arlene all sorts of tests and X-ray treatments for this “Hodgkin’s disease-?” and there were special meetings to discuss this peculiar case. I remember waiting for her outside, in the hall. When the meeting was over, the nurse wheeled her out in a wheelchair. All of a sudden a little guy comes running out of the meeting room and catches up with us. ”Tell me,” he says, out of breath; “do you spit up blood? Have you ever coughed up blood?” ,
The nurse says, “Go ‘away! Go away! What Kind of thing is that to ask of a patient!”-and brushes him away. Then she turned to us and said, “That man is a doctor from the neighborhood who comes to the meetings and is always making trouble. That’s not the kind of thing to ask of a patient!”

I didn’t catch on. The doctor was checking a certain possibility, and if I had been smart, I would have asked him what it was.
Finally, after a lot of discussion, a doctor at the hospital tells me they figure the most likely possibility is Hodgkin’s disease. He says, “There will be some periods of improvement, and some periods in the hospita1.,It will be on and off, getting gradually worse. There’s no way to reverse it entirely .. It’s fatal after a few years.”

“I’m sorry to hear that,” I say. “I’ll tell her what you said. ”
“No, no!” says the doctor. “We don’t want to upset the patient. “We’re going to tell her it’s glandular fever.”
“No, no!” I reply. “We’ve already discussed the possibility of Hodgkin’s disease. I know she can adjust to it.”
“Her parents don’t want her to know. You had better talk to them first.” ..

At home, everybody worked on me: my parents, my two aunts, our family doctor; they were all on me, saying I’m a very foolish young man who doesn’t realize what pain he’s going to bring to this wonderful girl by telling her she has a fatal disease. “How can you do such a terrible thing?” they asked, in horror.
“Because we have made a pact that we must speak honestly with each other and look at everything directly. ‘ There’s no use fooling around. She’s gonna ask me what she’s got, and I cannot lie to her!”.

“Oh, that’s childish!” they said-blah, blah, blah. Everybody kept working on me, and said I was wrong. I thought I was definitely right, because. I had already talked to Arlene about the disease and knew she could face it- that telling her the truth was the right way to handle it.

But finally, my little sister comes up to me-she was eleven or twelve then-with tears running down her face. She beats me on the chest, telling me that Arlene is such a wonderful girl, and that I’m such a foolish, stubborn brother. I couldn’t take it anymore. That broke me down.
So I wrote Arlene a goodbye love letter, figuring that if she ever found out the truth after I had told her it was glandular fever, we would be through. I carried the letter with me all the time.

The gods never make it easy; they always make it harder. I go to the hospital to see Arlene-having made this ‘decision-and there she is, sitting up in bed, surrounded by her parents, somewhat distraught. When she sees me, her face lights up and she says, “Now I know how valuable it is that we tell each other the truth!” Nodding at her parents, she continues, “They’re telling me I have glandular fever, and I’m not sure whether I believe them or not. Tell me, Richard, do I have Hodgkin’s disease or glandular fever?”
“You have glandular fever,” I said, and I died inside.
It was terrible—:-just terrible!
Her reaction was completely simple: “Oh! Fine! Then I believe them.” Because we had built up so much trust in each other, she was completely relieved. Everything was solved, and all was very nice.
She got a little bit better, and went home for a while.